Individual provider Active NPI

Blanca Erika Pena, DDS

  • General Practice Dentistry
  • Dallas, TX
National Provider Identifier
1740433242
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
23978 Issued in TX
Practice address
8515 Greenville Ave Ste N108
Dallas, TX 75243-7035
Phone
(214) 221-0855
Fax
(214) 221-1437
NPI assigned
Oct 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 23978 TX
General Practice Dentistry 1223G0001X 23978 TX Primary

Addresses

Primary practice location

8515 Greenville Ave Ste N108
Dallas, TX 75243-7035

Mailing address

8515 Greenville Ave Ste N108
Dallas, TX 75243-7035
Phone (214) 221-0855

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160112003274 TX Order and Referring Only - DentistPractitioner - Dentist 6608178397

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23978TXMDDentist

Interoperability endpoints

  • Direct secure messaging: blanca.pena@hhm.eclinicaldirectplus.com

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1740433242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8515 GREENVILLE AVE STE N108",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752437035",
            "telephone_number": "214-221-0855",
            "fax_number": "214-221-1437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8515 GREENVILLE AVE STE N108",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752437035",
            "telephone_number": "214-221-0855",
            "fax_number": "214-221-1437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "BLANCA",
        "middle_name": "ERIKA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-28",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "23978",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "23978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.